3 years ago

Laparoscopic assisted pancreaticoduodenectomy vs. totally laparoscopic pancreaticoduodenectomy for malignant tumor: a retrospectively controlled study

Guo-Liang Yao, Jing-Ming Zhai

Background Laparoscopic pancreaticoduodenectomy was now accepted worldwide with potential advantages over open pacreaticoduodenectomy. The defect was time wasting with the prone of increased postoperative complications. To assess the potential superiority and feasibility of laparoscopic assisted pancreaticoduodenectomy (LAPD) comparing to totally laparoscopic pancreaticoduodenectomy (TLPD), we introduce this study.

Methods Retrospectively analyzed the relation data from the patients who had laparoscopic pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital of Henan University of Science and Technology during January 2015 to July 2019. Complications and operation time were compared. SPSS 16.0 was employed for analysis.

Results Both groups had almost the same baseline characteristics, such as Sex (P=0.880), Age (P=0.861), ASA (P=0.559), BMI (P=0.854), pancreatic duct size (P=0.623), pancreatic texture (P=0.573) and tumor origin (P=0.878). LAPD was association to shorter operation time (231.6±43.7 min VS. 305.4±55.3 min; P=0.047), pancreaticojejunostomy time (13.8±4.2 min VS. 41.6±9.4 min; P=0.007), gastrojejunostomy time (10.9±3.0 min VS. 24.8±6.5 min; P=0.014) and jejunojejunostomy time (7.8±2.4 min VS. 23.4±5.8 min; P=0.005). No statistical difference was observed relation to resection time (P=0.864), cholangiojejunostomy time (P=0.897), blood loss (P=0.723), number of required transfusion (P=0.809), and incision length (P=0.183). Both groups had comparable conversion to open approach (P=0.402). LAPD had comparable complications to TLPD, such as pancreatic leakage (P=0.328), biliary leakage (P=0.673), bleeding (P=0.889), pneumonia (P=0.809) and thrombosis (P=0.443) and incision infection (P=0.889). No statistical difference was observed relation to visual analogue score at 1 day postoperatively (P=0.913) and hospitalization (P=0.137).

Conclusions Laparoscopic assisted pancreaticoduodenectomy with open pancreaticojejunostomy should be a choice for certain surgeons with less operation time.

Publisher URL: https://www.researchsquare.com/article/rs-17646/v1

DOI: 10.21203/rs.3.rs-17646/v1

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